Radiation Oncology Physics

1 Radiation Oncology Physics : A Handbook for Teachers and PodgorsakTechnical EditorSponsored by the IAEA and endorsed by the COMP/CCPM, EFOMP, ESTRO, IOMP, PAHO and WHOC over photograph courtesy of E. IzewskiRADIATION Oncology Physics :A HANDBOOK FOR TEACHERS AND STUDENTSThe following States are Members of the International atomic Energy Agency:The Agency s Statute was approved on 23 October 1956 by the Conference on the Statute of the IAEA held at United Nations Headquarters, New York; it entered into force on 29 July 1957. The Headquarters of the Agency are situated in Vienna. Its principal objective is to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world .AFGHANISTANALBANIAALGERIAANGOLAARGENTIN AARMENIAAUSTRALIAAUSTRIAAZERBAIJANBANGLA DESHBELARUSBELGIUMBENINBOLIVIABOSNIA AND HERZEGOVINABOTSWANABRAZILBULGARIABURKINA FASOCAMEROONCANADACENTRAL AFRICAN REPUBLICCHILECHINACOLOMBIACOSTA RICAC TE D IVOIRECROATIACUBACYPRUSCZECH REPUBLICDEMOCRATIC REPUBLIC OF THE CONGODENMARKDOMINICAN REPUBLICECUADOREGYPTEL SALVADORERITREAESTONIAETHIOPIAFINLANDFRA NCEGABONGEORGIAGERMANYGHANAGREECEGUATEMA LAHAITIHOLY SEEHONDURASHUNGARYICELANDINDIAINDONESIAI RAN, ISLAMIC REPUBLIC OF IRAQIRELANDISRAELITALYJA M A I CAJA PANJORDANKAZAKHSTANKENYAKOREA.

2 REPUBLIC OFKUWAITKYRGYZSTANLATVIALEBANONLIBERIALI BYAN ARAB JAMAHIRIYALIECHTENSTEINLITHUANIALUXEMBOU RGMADAGASCARMALAYSIAMALIMALTAMARSHALL ISLANDSMAURITANIAMAURITIUSMEXICOMONACOMO NGOLIAMOROCCOMYANMARNAMIBIANETHERLANDSNE W ZEALANDNICARAGUANIGERNIGERIANORWAYPA K I S TA NPA NA M APA R AG UAYPERUPHILIPPINESPOLANDPORTUGALQATARREP UBLIC OF MOLDOVAROMANIARUSSIAN FEDERATIONSAUDI ARABIASENEGALSERBIA AND MONTENEGROSEYCHELLESSIERRA LEONESINGAPORESLOVAKIASLOVENIASOUTH AFRICASPAINSRI LANKASUDANSWEDENSWITZERLANDSYRIAN ARAB REPUBLICTAJIKISTANTHAILANDTHE FORMER YUGOSLAV REPUBLIC OF MACEDONIATUNISIATURKEYUGANDAUKRAINEUNITE D ARAB EMIRATESUNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELANDUNITED REPUBLIC OF TANZANIAUNITED STATES OF AMERICAURUGUAYUZBEKISTANVENEZUELAVIETNAM YEMENZAMBIAZIMBABWERADIATION Oncology Physics : A HANDBOOK FOR TEACHERS AND STUDENTSI N TE R NAT I O NA L ATO MI C E NE RG Y AG E N C YVIENNA, 2005 IAEA Library Cataloguing in Publication DataRadiation Oncology Physics : a handbook for teachers and students / editor E.

3 B. Podgorsak ; sponsored by IAEA .. [et al.]. Vienna : International atomic Energy Agency, ; 24 cm. STI/PUB/1196 ISBN 92 0 107304 6 Includes bibliographical references. 1. Radiation dosimetry Handbooks, manuals, etc. 2. Dosimeters Handbooks, manuals, etc. 3. Radiation Measurement Handbooks, manuals, etc. 4. Radiation Dosage Handbooks, manuals, etc. 5. Radiotherapy Handbooks, manuals, etc. 6. Photon beams. 7. Electron beams. 8. Radioisotope scanning. I. Podgorsak, E. B., ed. II. International atomic Energy 05 00402 COPYRIGHT NOTICEAll IAEA scientific and technical publications are protected by the terms of the Universal Copyright Convention as adopted in 1952 (Berne) and as revised in 1972 (Paris).

4 The copyright has since been extended by the World Intellectual Property Organization (Geneva) to include electronic and virtual intellectual property. Permission to use whole or parts of texts contained in IAEA publications in printed or electronic form must be obtained and is usually subject to royalty agreements. Proposals for non-commercial reproductions and translations are welcomed and will be considered on a case by case basis. Enquiries should be addressed by email to the Publishing Section, IAEA, at or by post to:Sales and Promotion Unit, Publishing SectionInternational atomic Energy AgencyWagramer Strasse 5P. O . B o x 1 0 0A-1400 ViennaAustriafax: +43 1 2600 29302tel.

5 : +43 1 2600 22417 IAEA, 2005 Printed by the IAEA in AustriaJuly 2005 STI/PUB/1196 FOREWORDIn the late 1990s the IAEA initiated for its Member States a systematic and comprehensive plan to support the development of teaching programmes in medical Radiation Physics . Multiple projects were initiated at various levels that, together with the well known short term training courses and specialization fellowships funded by the IAEA Technical Cooperation programme, aimed at supporting countries to develop their own university based master of science programmes in medical Radiation of the early activities of the IAEA in this period was the development of a syllabus in radiotherapy Physics , which had the goal of harmonizing the various levels of training that the IAEA provided.

6 This was carried out during 1997 1998, and the result of this work was released as a report used for designing IAEA training courses. In 1999 2000 a more detailed teachers guide was developed, in which the various topics in the syllabus were expanded to form a detailed bullet list containing the basic guidelines of the material to be included in each topic so that lectures to students could be prepared accordingly. During the period 2001 2002 Podgorsak (Canada) was appointed editor of the project and redesigned the contents so that the book became a comprehensive handbook for teachers and students, with coverage deeper than a simple teachers guide. The initial list of topics was expanded considerably by engaging an enhanced list of international contributors.

7 The handbook was published as working material in 2003 and placed on the Internet in order to seek comments, corrections and handbook aims at providing the basis for the education of medical physicists initiating their university studies in the field. It includes the recent advances in radiotherapy techniques; however, it is not designed to replace the large number of textbooks available on radiotherapy Physics , which will still be necessary to deepen knowledge in the specific topics reviewed here. It is expected that this handbook will successfully fill a gap in the teaching material for medical Radiation Physics , providing in a single manageable volume the largest possible coverage available today.

8 Its wide dissemination by the IAEA will contribute to the harmonization of education in the field and will be of value to newcomers as well as to those preparing for their certification as medical physicists, Radiation oncologists, medical dosimetrists and radiotherapy of this handbook has been granted by the following international organizations and professional bodies: the International Organization for Medical Physics (IOMP), the European Society for Therapeutic Radiology and Oncology (ESTRO), the European Federation of Organisations for Medical Physics (EFOMP), the World Health Organization (WHO), the Pan American Health Organization (PAHO), the Canadian Organization of Medical Physicists (COMP) and the Canadian College of Physicists in Medicine (CCPM).

9 The following international experts are gratefully acknowledged for making major contributions to the development of an early version of the syllabus: B. Nilsson (Sweden), B. Planskoy (United Kingdom) and Rosenwald (France). The following made major contributions to this handbook: R. Alfonso (Cuba), G. Rajan (India), W. Strydom (South Africa) and N. Suntharalingam (United States of America). The IAEA scientific officers responsible for the project were (in chronological order) P. Andreo, J. Izewska and NOTEA lthough great care has been taken to maintain the accuracy of information contained in this publication, neither the IAEA nor its Member States assume any responsibility for consequences which may arise from its use of particular designations of countries or territories does not imply any judgement by the publisher, the IAEA, as to the legal status of such countries or territories, of their authorities and institutions or of the delimitation of their mention of names of specific companies or products (whether or not indicated as registered)

10 Does not imply any intention to infringe proprietary rights, nor should it be construed as an endorsement or recommendation on the part of the authors are responsible for having obtained the necessary permission for the IAEA to reproduce, translate or use material from sources already protected by , also referred to as Radiation therapy, Radiation Oncology or therapeutic radiology, is one of the three principal modalities used in the treatment of malignant disease (cancer), the other two being surgery and chemotherapy. In contrast to other medical specialties that rely mainly on the clinical knowledge and experience of medical specialists, radiotherapy, with its use of ionizing Radiation in the treatment of cancer, relies heavily on modern technology and the collaborative efforts of several professionals whose coordinated team approach greatly influences the outcome of the radiotherapy team consists of Radiation oncologists, medical physicists, dosimetrists and Radiation therapy technologists.